Incidence, prevalence, and trend data across races and ethnicities are presented as available. For some conditions for which there is active surveillance, such as cancer, data are routinely collected and presented by race or ethnicity. For other conditions, data are available from the published literature.

BOX 3-2

Interpretation of Changes in Incidence

In looking at changes in incidence, it is important to consider whether an increase or a decrease in a rate is due to a real trend in occurrence or to a change in diagnostic criteria, sensitivity of diagnostic tests, screening programs, or another external factor that changes the likelihood of finding a case and might make it appear that incidence is changing (Devesa et al., 1984). For example, some increases seen in breast-cancer incidence have been attributed to more intensive screening programs increasing the ascertainment of cases and not an increase in the secular trend (Seigneurin et al., 2008).

focused on the most appropriate and relevant conditions and end points, whether it is studying the most relevant groups of women, and whether the most appropriate research methods are being used.

CONDITIONS ON WHICH RESEARCH HASCONTRIBUTED TO MAJOR PROGRESS

Breast Cancer

The committee considered a large and diverse body of scientific research on breast cancer to have contributed to major progress in understanding the basic biology of breast cancer and the identification of specific risk factors, which led to prevention efforts; in improvements in the detection and treatment of breast cancer; and ultimately in a decrease in mortality rates.

Incidence, Prevalence, and Mortality in Women

During the last 2 decades, there has been heavy investment in breast-cancer research owing in part to the lobbying efforts of breast-cancer survivors and

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